Impact of the COVID-19 pandemic on Bordetella pertussis infections in England

Abstract

Background In March 2020, England went into its first lockdown in response to the COVID-19 pandemic. Restrictions eased temporarily, followed by second and third waves in October 2020 and January 2021. Recent data showed that the COVID-19 pandemic resulted in reduced transmission of some invasive diseases. We assess the impact of the COVID-19 pandemic on pertussis incidence and on the immunisation programme in England. Methods We assessed trends in pertussis cases from 2012 to 2020 by age group and month. Incidence from the time that England eased its initial lockdown measures in July 2020 through to summer 2021 was calculated and the incidence rate ratios of pertussis cases from five years prior to the pandemic (July 2014 – June 2019) compared to the same time period during the pandemic (July 2020 – June 2021). Vaccine coverage estimates for pertussis containing vaccines were reviewed for the maternal and childhood programmes. Results A substantial decline in pertussis cases was observed from April 2020 onwards, marking the lowest number of cases in the last decade. Pertussis incidence dropped in all age groups, particularly among infants less than one year old (0.50 / 100,000 during July 2020 to June 2021 compared to 24.49/ 100,000 from July 2014 to June 2019). The incidence rate ratio was 0.02 (95% CI 0.01 to 0.02) for July 2014 to June 2019 (pre-pandemic) compared to the pandemic period of July 2020 to June 2021. None of the cases had a co-infection with SARS-CoV-2. Vaccine coverage for infants born between January to March 2020 with three doses of pertussis vaccine by 12 months of age decreased by 1.1% points compared to infants born between January to March 2019 (91.6% and 92.7%, respectively). Prenatal pertussis coverage for the 2020 to 2021 financial year was 2.7% points lower than the year prior to the pandemic (70.5% and 76.8%, respectively). Conclusions Lockdown measures due to the COVID-19 pandemic have had a significant impact on pertussis transmission. With the easing of restrictions it is important to continue monitoring pertussis cases in England alongside coverage of the maternal and childhood immunisation programmes.

Bordetella pertussis, Chlamydia pneumoniae, and Mycoplasma pneumoniae Findings in Children During COVID-19 Pandemic in Finland

“…The observed decrease in B. pertussis was 88% in our study, whereas the English study presented a decrease of 97%, but the detection rates in this study were relatively rare (only 21 detections in 2021), so these findings were practically similar [ 7 ]. The results of this study are also similar to the previous reports regarding the decrease in the detections of M. pneumoniae [ 8 – 11 ].…”

“…A previous study from England reported a 98% reduction in Bordetella pertussis detections among infants (age less than 1 years) [ 7 ]. A study from Israeli found that the rates of B. pertussis and Mycoplasma pneumoniae decreased in hospitalized patients with respiratory tract infections during the early months of the pandemic.…”

The decline in immunity and circulation of pertussis among Chinese population during the COVID-19 pandemic: A cross-sectional sero-epidemiological study

“…While the estimated rate of recent infection in this study was lower than that in a previous study in Zhejiang during September and October 2014 [20] . This discrepancy might be influenced by the pandemic COVID‐19 as many strict prevention and control measures were implemented in 2020, which may reduce the circulation of pertussis bacteria [33] . In addition, since pertussis was a cyclic disease, the downward trend always come after the peak of the disease.…”

COVID-19: Consequences on pregnant women and neonates

“…No concurrent SARS-CoV-2 cases were detected. Prenatal pertussis prevalence was 2.7% lesser in 2020-2021 [84] .…”